Ovarian aging is a reproductive endocrine disease caused by a variety of factors leading to a gradual decline in ovarian function until ovarian failure， which seriously affects women's physical and reproductive health and is a major factor leading to female infertility. Mitochondria， the energy metabolism centers of cells， are critical for ovarian functions. Their structural and functional abnormalities are key pathological factors leading to the declined ovarian function. Mitochondrial quality control is an important endogenous regulatory mechanism for the maintenance of mitochondrial homeostasis and the improvement of mitochondrial functions. Abundant studies have shown that the dysregulation of mitochondrial quality control， characterized by mitochondrial oxidative damage， abnormal mitochondrial biogenesis， abnormal mitochondrial dynamics， abnormal mitochondrial autophagy， and dysregulated calcium homeostasis， is closely associated with the occurrence of ovarian hypofunction. Traditional Chinese medicine （TCM） is a treasure of China's medicine， demonstrating remarkable efficacy in the clinical treatment of ovarian aging-related diseases. In recent years， research progress has been achieved in the TCM treatment of ovarian aging by regulating mitochondrial quality control disorders in a multi-target and multi-pathway manner. However， systematic research remains to be carried out regarding the research progress in this field. Therefore， this article reviews the research progress in the TCM treatment of ovarian aging based on mitochondrial quality control， with a view to providing a theoretical basis for studying the clinical efficacy of TCM in the treatment of ovarian aging and a new strategy for the in-depth research on the prevention and treatment of ovarian aging by TCM.

Objective:To evaluate the relationship between red blood cell distribution width (RDW) and prognosis of patients with hepatocellular carcinoma (HCC) andergoing transcatheter arterial chemoembolization (TACE).Methods:Clinical data of 212 patients with HCC andergoing TACE for the first time in Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical University from January 2011 to May 2018 were retrospectively analyzed, including 184 males and 28 females, aged (56.8±11.2) years. Follow-up for survival. X-tile software was used to determine 13.1% as the optimal threshold for preoperative RDW prediction of prognosis, and enrolled patients were divided into a low level group (RDW<13.1%, n=70) and a high level group (RDW≥13.1%, n=142). Aspartate aminotransferase, total bilirubin, albumin, hemoglobin and lipoprotein a, Barcelona clinical liver cancer (BCLC) stage and other indexes were compared between the two groups. Survival analysis was performed by Kaplan-Meier method, survival rate was compared by log-rank test, and the effect of RDW on prognosis was analyzed by Cox regression. Results:The 1-year, 2-year and 3-year cumulative survival rates in RDW high level group were 34.5%, 14.1% and 6.3%, respectively, while those in RDW low level group were 64.3%, 38.6% and 21.4%, respectively, with significant difference ( χ2=23.09, P<0.001). Compared with the low level group, the levels of aspartate aminotransferase and total bilirubin were higher, the levels of albumin, hemoglobin and lipoprotein a were lower, the proportion of portal vein cancer thrombin was higher, and the stage of BCLC was later, with statistical significance (all P<0.05). Cox regression analysis showed that HCC patients with RDW≥13.1%( HR=1.732, 95% CI: 1.223-2.452, P=0.002) had poor survival prognosis after TACE. Conclusion:Preoperative RDW≥13.1% is an independent risk factor for survival after TACE in patients with HCC. RDW has potential predictive value for prognosis of patients with HCC.

Objective:To explore the application of observation teaching discussion (OTD) in vascular surgery nursing intern teaching under the guidance of process-oriented guided inquiry learning (POGIL) theory.Methods:Forty nursing students who were doing their internship in The First Affiliated Hospital of Xi'an Jiaotong University from July 2022 to July 2023 were randomly divided into two groups using a random number table: control group (20 students, OTD teaching) and observation group (20 students, POGIL theory-guided teaching) . The two groups were compared for competence assessment scores before entering the department and 3 days prior to departure from the department, autonomous learning ability scale scores, Competency Inventory for Registered Nurses (CIRN) scores, and Chinese Problem Solving Inventory (CPSI) scores. T-tests and chi-square tests were conducted using SPSS 22.0. Results:Three days prior to departure from the department, the theoretical performance and practical performance were significantly better in the observation group [(91.67±5.22) and (89.69±4.36) points, respectively] than in the control group [(84.53±4.75) and (82.41±4.18) points, respectively] ( P<0.05). The observation group also performed significantly better than the control group in autonomous learning ability scale score [(139.52±13.52) vs. (128.86±10.76)], CIRN score [(207.73±6.23) vs. (195.67±5.98)], and CPSI score [(103.60±4.72) vs. (92.18±5.03)] (all P<0.05). Conclusions:The application of OTD in vascular surgery nursing intern teaching under the guidance of POGIL theory can improve the autonomous learning ability, core ability, and problem-solving ability of nursing interns.

Objective To summarize and analyze the clinical first aid characteristics and etiology classi-fication of adult acute laryngeal obstruction so as to guide the targeted treatment in clinic.Methods The clini-cal data of the patients with the main symptoms such as suffocation and inspiratory dyspnea visiting in this hospital from January 2015 to December 2021 were collected.They conducted emergency tracheotomy for first aid,and their etiological distribution and characteristics were analyzed.Results A total of 94 patients with a-cute laryngeal obstruction and emergency tracheotomy caused by various causes were collected,73 males and 21 females,aged (65.44±12.23)years old.The proportions of disease causes from high to low were in turn 60 cases of tumor (63.83％),12 cases of bilateral vocal cord paralysis (12.77％),11 cases of inflammation (11.70％),5 cases of trauma (5.32％),2 cases of laryngeal edema (2.13％),2 cases of giant foreign matter (2.13％) and 2 cases of tube taking off after tracheotomy (2.13％).The age had the statistical difference a-mong different etiologies (F=4.463,P=0.001).The age in the patients with tumor,infection and bilateral vocal cord paralysis was greater than that of the other groups with statistical difference[(67.21±10.45)years old vs.(52.00±16.42)years old,t=2.993,P=0.012].The male patients with different severities of acute la-ryngeal obstruction were more than female patients,but the difference in the sex composition was not statisti-cally significant (P=0.469).Among the patients with emergency tracheotomy,there were 6 cases of compli-cating incision bleeding and 5 cases of subcutaneous emphysema;1 case of right pneumothorax complicating apposite side atelectasis,and all were improved by symptomatic treatment.Conclusion Acute laryngeal ob-struction in adults is critical.The common causes include tumor,bilateral vocal cord paralysis and inflamma-tion.The risk of emergency tracheotomy and complications occurrence risk are relatively high.

Objective To optimize the culture and fermentation conditions of the Penicillium aurantiocandidum Z12 strain, a fungal strain with molluscicidal actions against Oncomelania hupensis, so as to provide the basis for the research and development of molluscicidal active substances from the P. aurantiocandidum Z12 strain and its fermentation broth and large-scale fermentation. Methods The carbon source, nitrogen source and mineral salts were identified in the optimal culture medium for the P. aurantiocandidum Z12 strain with a single-factor experiment to determine the best fermentation condition for the P. aurantiocandidum Z12 strain. Factors that significantly affected the growth of the P. aurantiocandidum Z12 strain were identified using the Plackett-Burman design, and the best range of each factor was determined using the steepest climb test. Response surface analyses of temperature, pH value, seeding amount and liquid-filling quantity were performed using the Box-Behnken design to create a regression model for fermentation of the P. aurantiocandidum Z12 strain to identify the optimal culture medium. Results Single-factor experiment preliminarily identified the best culture medium and conditions for the P. aurantiocandidum Z12 strain as follows: sucrose as the carbon source at approximately 20 g/L, tryptone as the nitrogen source at approximately 5 g/L, K₂HPO₄ as the mineral salt at approximately 5 g/L, initial pH at approximately 8, temperature at approximately 28 °C, seeding amount at approximately 6%, and liquid-filling quantity at approximately 50 mL/100 mL. Plackett-Burman design showed that factors that significantly affected the growth of the P. aurantiocandidum Z12 strain included temperature (t = −5.28, P < 0.05), seeding amount (t = 5.22, P < 0.05), pH (t = −4.30, P < 0.05) and liquid-filling quantity (t = −4.39, P < 0.05). Steepest climb test showed the highest mycelial growth at pH of 7.5, seeding amount of 8%, and liquid-filling quantity of 40 mL/100 mL, and this condition was selected as the central point of response surface analysis for the subsequent optimization of fermentation conditions. Response surface analyses using the Box-Behnken design showed that the optimal conditions for fermentation of the P. aurantiocandidum Z12 strain included sucrose at 15 g/L, tryptone at 5 g/L, K₂HPO₄ at 5 g/L, temperature at 28.2 °C, pH at 7.5, seeding amount at 10%, and liquid-filling quantity at 35.8 mL/100.0 mL, resulting in 0.132 g yield of the P. aurantiocandidum Z12 strain. Conclusion The optimal culture condition for the P. aurantiocandidum Z12 strain has been identified, and the optimized culture medium and fermentation condition may effectively improve the fermentation yield of the P. aurantiocandidum Z12 strain.

Humans ; Cardiologists ; Neoplasms/drug therapy* ; Medical Oncology ; Heart ; Oncologists

Postpartum lochia （PL） is an abnormal postpartum retrogression disease characterized by persistent bloody lochia lasting for more than 10 days. The pathogenesis of traditional Chinese and western medicine is complex，and the mechanism of drug action is not yet clear. The author summarized the pathogenesis and drug action mechanism of postpartum lochia from the perspectives of traditional Chinese and Western medicine by reviewing relevant domestic and foreign research in recent years. It was found that the basic pathogenesis of this disease is the imbalance of Chong Ren Qi and blood，multiple deficiency and multiple stasis. Commonly used drugs are divided into single traditional Chinese medicine and traditional Chinese medicine compound formulas and their preparations. By regulating the transcription and expression of related factors through multiple targets and pathways，it promotes uterine contraction，regulates collagen metabolism Regulating the expression of hormones and their receptors，promoting vascular regeneration，regulating cell apoptosis，proliferation and differentiation，downregulating inflammatory response，maintaining blood coagulation balance，and affecting energy metabolism in the body can promote postpartum recovery. Western medicine is often associated with mechanisms such as incomplete uterine involution，residual tissue，and intrauterine infections. The treatment mainly involves the combination of uterine contractions and antibiotics，with a single mode of action and mechanism. Therefore，traditional Chinese medicine has obvious and concrete advantages in treatment. This article aims to review the etiology and pathogenesis of postpartum lochia in traditional Chinese and western medicine，as well as drug treatment. It aims to construct the relationship between its pathogenesis and mechanism of action，providing reference for the clinical diagnosis and treatment of this disease and drug research and development.

Objective:To investigate the effect of deescalation noninvasive positive pressure ventilation in the removal of endotracheal intubation in patients with Stanford type A aortic dissection (AAD) complicated with obesity.Methods:A total of 80 obese patients with AAD from March 2018 to January 2020 in the First Affiliated Hospital of Xi′an Jiaotong University were divided into experimental group and control group with 40 cases in each group by random number table method. The control group received traditional oxygen treatment with mask, while the experimental group received de-escalation noninvasive positive pressure ventilation. The blood gas index, respiratory rate and respiratory comfort score was recorded at different times before and after intervention, make a comparison with the two groups in the incidence of hypoxemia, secondary intubation and other complications.Results:Finally, 36 cases were included in the experimental group and 38 cases in the control group. After 2, 8, 24, 48, 72 h of extubation, the oxygenation index, PaO 2, SaO 2 were higher and PaCO 2, respiratory rate were lower in the experimental group compared to the control group, the differences were statistically significant ( t values were 2.02-9.00, all P<0.05). At 72 h after extubation, the pH value of the experimental group was 7.43 ± 0.08, which was higher than 7.38 ± 0.09 of the control group, and the difference was statistically significant ( t=2.44, P<0.05). At 24, 48, 72 h after extubation, the throat pain scores and oral nasal dryness symptom and sore throat symptom scores were (3.11 ± 1.53), (2.25 ± 0.57), (0.94 ± 0.14) points and (4.33 ± 1.08), (3.33 ± 0.68), (2.81 ± 0.43) points in the experimental group, lower than in the control group (5.24 ± 1.96), (3.58 ± 0.73), (2.18 ± 0.91) points and (6.00 ± 1.92), (5.39 ± 1.13), (4.79 ± 0.54) points, the differences were statistically significant ( t values were 3.46-5.21, all P<0.05). The incidence of hypoxemia, secondary intubation and intolerance were 2.8% (1/36), 2.8% (1/36) and 0 in the experimental group, lower than in the control group 26.3% (10/38), 21.1% (8/38) and 10.5% (4/38), the differences were statistically significant ( χ2=8.09, 5.78, 4.01, all P<0.05). Conclusions:De-escalation noninvasive positive pressure ventilation for obese patients with AAD can effectively improve oxygenation, reduce the incidence of hypoxemia and secondary intubation, and alleviate respiratory symptoms.

Objective:To present the clinical characteristics and treatment on patients with ectopic adrenocorticotropic hormone(ACTH) syndrome (EAS) caused by the retroperitoneal paraganglioma.Methods:The clinical data of a case of EAS caused by retroperitoneal paraganglioma were analyzed retrospectively, and the related literature at home and abroad was reviewed.Results:The 53-year-old female patient was admitted to endocrinology department due to a fifteen-year history of hypertension, accompanied by fatigue for three months, headache and dizziness for one month. The laboratory data demonstrated severe hypokalemia, high level of serum and urinary cortisol, while the ACTH level remained unsuppressed. The 24 h urinary vanillyl mandelic acid (VMA) and serum free methoxyepinephrine (MNs) level were elevated. The abdominal computed tomographic scan suggested a retroperitoneal mass next to the abdominal aorta. After the retroperitoneal tumor resection was performed, immunohistochemical staining of the tumor revealed Syn (+ ), CgA (+ ), ACTH (focal + ). By the retrospective analysis of 22 similar cases from 16 papers and the case summarized above, we found that most patients with EAS caused by the paraganglioma could demonstrate the typical clinical features of Cushing′s syndrome, while lack of the manifestation of paraganglioma. Therefore, preoperative preparations for paraganglioma were usually neglected.Conclusions:Ectopic ACTH syndrome (EAS) originating from paraganglioma is very rare. To improve the diagnosis rate, examination for catecholamine, MNs and 24 h urinary VMA before surgery in patients with EAS is suggested. Considering surgical resection as the optimal treatment, comprehensive preoperative preparations for both paraganglioma and Cushing′s syndrome are significant. A genetic test for pheochromocytoma/ paraganglioma and lifelong postoperative follow-up are also recommend.

Objective To investigate the epidemiological characteristics of renal transplantation recipients, effective prevention and control measures. Methods A total of 456 renal transplant recipients were monitored from January 2014 to December 2017. Postoperative infection including baseline data, infection site and infectious pathogen type was analyzed. Results Among 456 renal transplant recipients, 78 cases (17.1%) developed nosocomial infection. Postoperative infection time was 9(3-21) d. Infection sites mainly included the lower respiratory tract, urinary system and blood infection. Infection pathogens consisted of Staphylococci (n=13), Enterococcus faecium (n=6), fungi (n=6), Stenotrophomonas maltophilia (n=4), Acinetobacter baumannii (n=4), Pseudomonas aeruginosa (n=4), Staphylococcus epidermidis (n=4), Klebsiella pneumoniae (n=1), Escherichia coli (n=1) and other negative bacteria (n=9). Among them, 11 cases (14%) were infected with multi-drug resistant bacteria, and 4 cases died. Conclusions In renal transplant recipients, the incidence of nosocomial infection is relatively high, with early postoperative onset, common multiple drug-resistant bacterial infection and high mortality. Preoperative preparations should be fully implemented, postoperative lower respiratory tract infection should be actively prevented and prevention and treatment measures for multidrug-resistant bacteria should be standardized.